General Practice Forward View: How NHS England plans to help practices tackle their growing workload

The GP Forward View claims it wants to reduce practice burdens and help release time, but will it make a difference to practices' ballooning workloads?

NHS England has said it is serious about helping to reduce workload in general practice, but this section of the General Practice Forward View is perhaps one of the most disappointing.

It is hard to see any measures that are going to have an immediate impact on cutting workload – which was identified as the single biggest issue of concern to GPs and their staff in a BMA survey last year.

Releasing Time for Patients/Improving access

The big investment here is £30m of new funding for a three-year ‘Releasing Time for Patients’ development programme. This will build on the work that was undertaken to support practices taking part in the GP Access Fund schemes, which was apparently very successful at helping practices redesign services.

It’s not exactly clear what this money will pay for, but the Forward View says the main components are:

Innovations spread – a national programme to gather and disseminate successful examples and measure impact.

Service redesign – locally hosted action learning programmes with expert input to help practices and federations implement improvements that can release capacity

Capability building – investment and support to change ‘leadership capabilities’ in practices and federations

Practices in the GP Access Fund are also about to begin testing an automated appointment-measuring interface, which will give them detailed information about their activity to help them match appointment supply to demand. The GP Forward View says that this tool will be made available to every practice in 2017/18.

CQC inspections

The GP Forward View also confirms that CQC inspections will be scaled back once all practices have been inspected.

Those practices rated good or outstanding will only be inspected every five years, providing they make available transparent data to the CQC, NHS England and CCGs. This is a far cry from the total abolition of inspection that LMCs called for in their emergency meeting earlier this year and the GPC has already said it will continue to push for a further ‘scaling back’ of the inspection regime in general practice.

The Forward View does confirm that NHS England will ensure practices are ‘appropriately compensated’ for any further rise in CQC fees – although the GPC has said it is pushing for full reimbursement of all fees to be guaranteed.

A new set of key ‘sentinel’ indicators for quality in general practice will be published in July this year. It seems likely that this may be the data that the CQC will use to decide whether practices need inspecting sooner than the planned five-yearly check.

Reporting and payment systems

Practice managers in particular will be pleased to hear there are plans to simply how GP data and information is requested and shared. NHS England also says it will be simplifying the GP payment system to improve the consistency and accuracy of payments. As part of this it will assess whether a single payment system is possible.

Self care

By September this year NHS England will have launched a national programme to help practices support people living with long-term conditions.

The aim will be to equip practice staff with the tools and resources to help give patients the skills to better manage their own condition.

There are also plans to promote the development of social prescribing.

Practice resilience

The other big chunk of funding in the workload section is a further £40m for a practice resilience programme. NHS England plans to develop this with the RCGP and BMA ‘as quickly as possible’

It’s not exactly clear what this programme will do, and whether it will be available to all practices or only those identified as ‘vulnerable’.

Last year some 800 practices were identified as being ‘vulnerable’ and the Forward View confirms that from this month they will be able to access help from NHS England, providing they are prepared to ‘match fund’ the cost of the support available.

Changes to hospital contracts

Changes to hospital contracts that came into effect at the start of April should stop patients being bounced back to their GP if they fail to attend an outpatient appointment or if they need to be referred on to another service. Hospitals are also now required to supply patients with medication following discharge from inpatient or day case care.

Paper-free general practice

Finally, NHS England says it will be pushing forwards on creating a paper free general practice.

Apparently work is almost complete that will remove the need for practices to print paper copies of records when a patient moves practices. And by 2020 all incoming clinical correspondence from other NHS providers should be electronic and appropriately coded.